Association between Home Modification and Falls Among Older Adults: The Health and Retirement Study

TitleAssociation between Home Modification and Falls Among Older Adults: The Health and Retirement Study
Publication TypeThesis
Year of Publication2023
AuthorsZhu, SJie
Academic DepartmentGlobal Health
DegreeMaster of Science
UniversityDuke Kunshan University and Duke University
KeywordsOlder adults; Policy development; Home modifications; Healthcare professionals; Policymakers

Background: The aging population is rapidly increasing, and falls are a significant threat to the health and well-being of older adults. Falls are the leading cause of injury among individuals aged 65 and older, resulting in increased healthcare costs, morbidity, and mortality. Preventing falls among older adults requires a multifaceted approach that includes education, training, research, and policy development. While studies have evaluated the effectiveness of multifactorial interventions, little attention has been paid to home modification as a fall prevention strategy. The purpose of this study is to examine the impact of home modification on the episodes of falls and fall-related injuries among retired older adults in the United States who are living independently in the community. Using data from the Health and Retirement Study (HRS), we investigated whether home modification is associated with a lower episode of falls.

Method: This study utilized data from the Health and Retirement Study (HRS) to investigate the association between home modifications and falls among community-dwelling older adults in the United States. The study included 4,620 participants aged 60 years and older who completed surveys in 2006 and 2008. The primary outcome was the occurrence of falls during the follow-up period in 2008, and the secondary outcome was injury due to a fall. The binary variable for home modification was created based on whether participants reported having any home modifications in the last two years. Covariates included demographic characteristics, lifestyle factors, and health-related variables. Baseline demographic and health characteristics were described using means, standard deviations, counts, and proportions. Two-sample t-tests and chi-squared tests were used to compare continuous and categorical variables between participants with and without home modifications. Logistic regression models were used to assess the unadjusted and adjusted associations between home modifications and falls, adjusting for various covariates. Interaction analyses were conducted to examine the differences in associations by sex and age.

Result: This study aimed to investigate the association between home modification and falls among older adults. A total of 4,620 participants were included in the study, divided into two groups: those with and without home modification. The episodes of falls in the past two years were similar in both groups, with 25.94% in the home modification group and 25.08% in the non-home modification group. Participants with home modification had 17% lower odds of falls than those without home modification. Additionally, participants with home modification had 22% lower odds of fall-related injuries. The study found that the age category of 60-69 had the lowest episodes of falls, and female participants had a lower episode of falls than males after home modification. The presence of safety and getting around features in home modifications was also associated with a reduced episode of falls.

Conclusion: This study suggests that home modification can be an effective strategy to prevent falls and fall-related injuries among older adults living in the community. The findings are consistent with previous research and provide valuable information for healthcare professionals and policymakers to design interventions that include home modification to reduce the burden of falls and their associated injuries in older adults.

Citation Key13471